We consume it every day and typically pattern the activities of our day around food. New Zealanders can take pride in having one of the best food supplies in the world. How is it then that New Zealand adults now have the third highest rate of obesity in the OECD? How will this impact on the ageing of the population?
In the next 40 years a quarter of New Zealanders will be aged 65 or above. The fastest growing group are those over 85 years, growing from one to six per cent of the total population. What we eat affects our health and is a major determinant of how successfully we age. The foods we consume leading up to and during our older years is something we can modify and may impact on our quality of life.
Most people over the age of 65 are fit and healthy. There are a minority who lose their independence as a result of disability or chronic disease that may have been present for many years. The ageing of the population will increase the level of resources required for this growing minority but can only be partially supported by relatively fewer people at younger ages.
Among the very old, over 85 years, there is a growing body of evidence that about a third living independently in the community at high risk of malnutrition. Living alone is a strong predictor. Evidence suggests that eating is socially facilitated.
Simply presenting food at the front door will not solve the problem. It is the companionship a person receives when eating a meal that is important. An improvement in food intake may reduce the risk of hospitalisation, disability and residential care. Intervention is needed now to help these older people to maintain their health and independence.
Maintaining healthy eating habits leading up to older age may be even more of a challenge. The national nutrition survey showed compared to younger adults, those over 65 years are more likely to have breakfast; consume more fruit and vegetables; use low fat milk; remove excess fat from meat as well as eat less fast food and sugar sweetened beverages.
Food habits have changed. Today younger adults face a vastly different food environment to that of their parents. Healthy choices are no longer easy choices. The food supply is increasingly dominated by energy-dense, nutrient poor foods; especially the availability of prepared foods delivered through large portion sizes. This has had a major effect on diet related disease and weight status and will continue to do so unless stops are put in place.
Current food practices tend to be embedded in the economic, cultural, social, educational surroundings in which people live. The opportunities to access healthy food depend on the conditions of food access, quality and promotion of food and beverage choices.
Economic factors have a strong bearing. Food prices influence access to food and food choices. Among the health disparate food insecurity is emerging as an increasingly important problem. The City Mission now operates over 70 food banks in the Auckland region. New Zealanders living in the most deprived areas have higher rates of obesity; they also have higher levels of heart disease and diabetes and an unmet need for health care.
Education now places less of a focus on cooking skills in the school curriculum. There is a parallel decline in food literacy especially among younger people who may have no idea where food comes from.
It would seem that efforts to improve nutrition juncture with the development of knowledge and skills on how to use food to meet needs and determine intake. The future is bleak where the passive supermarket shopper has little idea how their food choices were grown, transported, or sold to them, nor of the social and environmental damage being caused.
Culture and family relationships strongly impact on food choices. Much can be learnt from traditional Maori food practices where procurement, preparation and eating of food are a shared activity. A holistic world view means that food supplies are sustainable.
Efforts to turn the tide on the way we eat are compounding both at an international and local level. Environmental interventions can create improved access and availability to healthy foods.
Policies are needed to improve food composition, pricing, promotion and provision. Government is in a position to take interventionist action. Policies can create healthy food environments to enhance future health. It is a matter of political will.
Dr Carol Wham is a senior lecturer with Massey University’s Institute of Food, Nutrition & Human Health.